Provider Demographics
NPI:1609979087
Name:AUDIOLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:AUDIOLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:JR
Authorized Official - Credentials:AUD
Authorized Official - Phone:734-241-4080
Mailing Address - Street 1:214 E ELM
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-7085
Mailing Address - Country:US
Mailing Address - Phone:734-241-4080
Mailing Address - Fax:734-241-4798
Practice Address - Street 1:214 E ELM
Practice Address - Street 2:SUITE 111
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2678
Practice Address - Country:US
Practice Address - Phone:734-241-4080
Practice Address - Fax:734-241-4798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501001058OtherHEALTH ALLIANCE PLAN
04156OtherNECP
MI540E810410OtherBCBS
MI640E810150OtherBCBS
MIRH000001OtherMESSA
OH03321OtherPARAMOUNT
MI0E81041OtherBLUE CARE NETWORK
MI3328905Medicaid
MI5501001058OtherHEALTH ALLIANCE PLAN
R75748Medicare UPIN